Osteopathic Medicine: A Reformation in Progress
http://www.100md.com
《美国整骨期刊》
As I get older, I seem to be more interested in history in general, but I find I am particularly fascinated by the history of the osteopathic medical profession. A Second Voice: A Century of Osteopathic Medicine in Ohio by Carol Poh Miller is an important contribution to the scholarly record of our profession.
As noted in the book's cover notes, A Second Voice has the added distinction of having been published concurrently with the 100th anniversary of the Ohio Osteopathic Association (OOA)—and having a forward written by Ohioan and 2004–2005 President of the American Osteopathic Association (AOA), George Thomas, DO.
Miller was commissioned by the OOA on this commemorative opportunity to carefully document the beginnings of osteopathic medicine in Ohio—a politically pivotal Midwestern state and a state with particular interest to the osteopathic profession in that osteopathic physicians practicing there can proudly declare that "although [they represent] just 12 percent of the total number of physicians in Ohio, they [represent] 26 percent of Ohio's family and general practice physicians."
Miller takes special care to detail the growth of the profession in that state through the current day. Many of the exciting movements within the larger profession are "fleshed out" in A Second Voice through well-chosen Ohio-specific details, from our collective trials and tribulations through our hard-won victories and swift and sometimes fortuitous turns of fate.
In the first of the book's six chapters, "Ohio's Osteopathic Pioneers," readers are introduced to the forebears of osteopathic medicine in that state, physicians who established offices before 1900 in Akron, Cleveland, Cincinnati, Columbus, Hamilton, Springfield, Toledo, and Warren. One readily notices the early and active involvement of women in this coterie. Miller writes, "the number of women is notable: denied entrance to most medical schools, they were welcomed into the osteopathic colleges."
In chapter 2, "The Struggle for Recognition and Equal Practice Rights," and chapter 3, "Moving Forward," the initial struggles of early osteopathic physicians to gain equal practice rights are carefully described. Despite the horrible professional discrimination endured, they were victorious in leading the way for osteopathic medicine as a viable healthcare option for Ohio's citizens and practitioners.
In chapter 4, "Postwar Strides and Setbacks," acceleration of the profession is well described, especially in efforts at internal fundraising and the steady creation of new osteopathic hospitals, which Miller describes as growing "prodigiously," noting that "[o]n the eve of World War II, there were six osteopathic hospitals; by 1965, there were seventeen." It is in this chapter that Miller details the 1961 merger between the California Medical Association and the California Osteopathic Medical Association, allowing osteopathic physicians "to exchange their DO degrees for MD certificates"—an event that brought a nationwide "jolt" to the profession.
Miller also discusses the way in which osteopathic physicians "were quietly winning the respect of their MD colleagues" during this postwar period, making special note of the effects of Public Law 763, which allowed osteopathic physicians to become commissioned medical officers in the armed services—a change that had great effect during the Vietnam War in particular.
In the fifth chapter, "An Ohio College of Osteopathic Medicine," the osteopathic profession is firmly established on Ohio's soil and readers have a sense of the hard work and extreme dedication necessary to make that dream a reality—a new reality that "[brought] a tremendous sense of pride and accomplishment to the state's professional association."
The last chapter, "A Second Voice," begins with the financial difficulties faced by the OOA after the Ohio University College of Osteopathic Medicine was established in Athens. The OOA's new executive director declared, "The profession is on the threshold of becoming a significant second voice in medicine." "We must respond to this role," he urged, "If we do not, we may just be wasting our time."
This chapter discusses topics as diverse (and often ongoing) as the increasingly prominent role of state and federal regulation in the practice of medicine, the rising power of local health planning agencies, challenges in raising the public's awareness of osteopathic medicine and building on gains made, the professional liability insurance crisis, the economic crises facing hospitals and the resulting mergers and acquisitions, regulations in dealing with alternative healthcare delivery systems (eg, health maintenance organization, preferred provider organizations), cutbacks in Medicare reimbursements, challenges to postdoctoral training and education programs, inadequate insurance reimbursements, and difficulty in securing managed-care contracts.
Another interesting feature of this book are the scattered profiles and vignettes of leaders of the profession from Ohio: Mac F. Hulett, DO; William E. Reese, DO; Emmons R. Booth, DO; James O. Watson, DO; William S. Konold; Richard A. Sheppard, DO; Donald C. Siehl, DO; and John P. Stevastos, DO. Indeed, many of the profession's current leaders are from this great state—including, as noted, the AOA's 2004–2005 president. These profiles nicely describe the efforts of these leaders and help readers better appreciate the time-tested strength of our profession.
The book's three thorough appendices are especially informative, offering, respectively, a "Timeline of Osteopathic Medicine in Ohio," complete with symbols indicating state milestones; "Past Presidents of the Ohio Osteopathic Association"; and "Ohio's Osteopathic Hospitals." This third appendix is accompanied by several evocative photographs that depict especially proud moments for osteopathic medicine in Ohio: groundbreaking ceremonies, the unveiling of progressively larger plans for institutional development, a nursery when the baby boom was underway, open houses, and building dedications. Although, sadly, many of these institutions no longer exist, in one way or another they all contributed to the history of osteopathic medicine in Ohio.
The history of the osteopathic medical profession in the state of Ohio is well preserved in this compact yet comprehensive volume. Although I certainly recommend A Second Voice: A Century of Osteopathic Medicine in Ohio for all individuals who have a particular interest in studying the roots of osteopathic medicine in the state of Ohio, I also believe A Second Voice is a valuable read for any individual who would like to further explore the evolution of a professional organization.
Footnotes
By Carol Poh Miller. 161 pp. $24.95. ISBN 0-8214-1594-8. Athens, Ohio: Ohio University Press; 2004.
Editor's note: JAOA—The Journal of the American Osteopathic Association strongly encourages interested parties to submit reviews for books on topics that might be of interest to THE JOURNAL's readers. Although JAOA is mainly interested in books about osteopathic medicine, we are also interested in books written by osteopathic physicians on any topic.(Gilbert E. D'Alonzo, JR, )
As noted in the book's cover notes, A Second Voice has the added distinction of having been published concurrently with the 100th anniversary of the Ohio Osteopathic Association (OOA)—and having a forward written by Ohioan and 2004–2005 President of the American Osteopathic Association (AOA), George Thomas, DO.
Miller was commissioned by the OOA on this commemorative opportunity to carefully document the beginnings of osteopathic medicine in Ohio—a politically pivotal Midwestern state and a state with particular interest to the osteopathic profession in that osteopathic physicians practicing there can proudly declare that "although [they represent] just 12 percent of the total number of physicians in Ohio, they [represent] 26 percent of Ohio's family and general practice physicians."
Miller takes special care to detail the growth of the profession in that state through the current day. Many of the exciting movements within the larger profession are "fleshed out" in A Second Voice through well-chosen Ohio-specific details, from our collective trials and tribulations through our hard-won victories and swift and sometimes fortuitous turns of fate.
In the first of the book's six chapters, "Ohio's Osteopathic Pioneers," readers are introduced to the forebears of osteopathic medicine in that state, physicians who established offices before 1900 in Akron, Cleveland, Cincinnati, Columbus, Hamilton, Springfield, Toledo, and Warren. One readily notices the early and active involvement of women in this coterie. Miller writes, "the number of women is notable: denied entrance to most medical schools, they were welcomed into the osteopathic colleges."
In chapter 2, "The Struggle for Recognition and Equal Practice Rights," and chapter 3, "Moving Forward," the initial struggles of early osteopathic physicians to gain equal practice rights are carefully described. Despite the horrible professional discrimination endured, they were victorious in leading the way for osteopathic medicine as a viable healthcare option for Ohio's citizens and practitioners.
In chapter 4, "Postwar Strides and Setbacks," acceleration of the profession is well described, especially in efforts at internal fundraising and the steady creation of new osteopathic hospitals, which Miller describes as growing "prodigiously," noting that "[o]n the eve of World War II, there were six osteopathic hospitals; by 1965, there were seventeen." It is in this chapter that Miller details the 1961 merger between the California Medical Association and the California Osteopathic Medical Association, allowing osteopathic physicians "to exchange their DO degrees for MD certificates"—an event that brought a nationwide "jolt" to the profession.
Miller also discusses the way in which osteopathic physicians "were quietly winning the respect of their MD colleagues" during this postwar period, making special note of the effects of Public Law 763, which allowed osteopathic physicians to become commissioned medical officers in the armed services—a change that had great effect during the Vietnam War in particular.
In the fifth chapter, "An Ohio College of Osteopathic Medicine," the osteopathic profession is firmly established on Ohio's soil and readers have a sense of the hard work and extreme dedication necessary to make that dream a reality—a new reality that "[brought] a tremendous sense of pride and accomplishment to the state's professional association."
The last chapter, "A Second Voice," begins with the financial difficulties faced by the OOA after the Ohio University College of Osteopathic Medicine was established in Athens. The OOA's new executive director declared, "The profession is on the threshold of becoming a significant second voice in medicine." "We must respond to this role," he urged, "If we do not, we may just be wasting our time."
This chapter discusses topics as diverse (and often ongoing) as the increasingly prominent role of state and federal regulation in the practice of medicine, the rising power of local health planning agencies, challenges in raising the public's awareness of osteopathic medicine and building on gains made, the professional liability insurance crisis, the economic crises facing hospitals and the resulting mergers and acquisitions, regulations in dealing with alternative healthcare delivery systems (eg, health maintenance organization, preferred provider organizations), cutbacks in Medicare reimbursements, challenges to postdoctoral training and education programs, inadequate insurance reimbursements, and difficulty in securing managed-care contracts.
Another interesting feature of this book are the scattered profiles and vignettes of leaders of the profession from Ohio: Mac F. Hulett, DO; William E. Reese, DO; Emmons R. Booth, DO; James O. Watson, DO; William S. Konold; Richard A. Sheppard, DO; Donald C. Siehl, DO; and John P. Stevastos, DO. Indeed, many of the profession's current leaders are from this great state—including, as noted, the AOA's 2004–2005 president. These profiles nicely describe the efforts of these leaders and help readers better appreciate the time-tested strength of our profession.
The book's three thorough appendices are especially informative, offering, respectively, a "Timeline of Osteopathic Medicine in Ohio," complete with symbols indicating state milestones; "Past Presidents of the Ohio Osteopathic Association"; and "Ohio's Osteopathic Hospitals." This third appendix is accompanied by several evocative photographs that depict especially proud moments for osteopathic medicine in Ohio: groundbreaking ceremonies, the unveiling of progressively larger plans for institutional development, a nursery when the baby boom was underway, open houses, and building dedications. Although, sadly, many of these institutions no longer exist, in one way or another they all contributed to the history of osteopathic medicine in Ohio.
The history of the osteopathic medical profession in the state of Ohio is well preserved in this compact yet comprehensive volume. Although I certainly recommend A Second Voice: A Century of Osteopathic Medicine in Ohio for all individuals who have a particular interest in studying the roots of osteopathic medicine in the state of Ohio, I also believe A Second Voice is a valuable read for any individual who would like to further explore the evolution of a professional organization.
Footnotes
By Carol Poh Miller. 161 pp. $24.95. ISBN 0-8214-1594-8. Athens, Ohio: Ohio University Press; 2004.
Editor's note: JAOA—The Journal of the American Osteopathic Association strongly encourages interested parties to submit reviews for books on topics that might be of interest to THE JOURNAL's readers. Although JAOA is mainly interested in books about osteopathic medicine, we are also interested in books written by osteopathic physicians on any topic.(Gilbert E. D'Alonzo, JR, )